| NPI | 1982304267 |
|---|---|
| Other Name | JERRY R ELLIS DDS PC |
| Entity Type | Organization |
| Authorized Contact | JERRY R ELLIS Owner/Dentist 972-775-2345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2023-04-20 |